Laparoscopic purse-string suture sac closure is appropriate procedure for children with unilateral indirect inguinal hernia: comparative study versus laparoscopic sac excision and closure procedure | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 36, Issue 4, October 2017 PDF (1.01 MB) | ||||
| DOI: 10.4103/ejs.ejs_62_17 | ||||
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| Authors | ||||
| Ayman Hasanein; Mohamed Rabea; Mohamed Fathi; Alaa El Sayed | ||||
| Abstract | ||||
| Objective Evaluation of immediate and 6-month postoperative (PO) outcomes of laparoscopic repair of unilateral indirect inguinal hernia (IIH) and comparison of outcomes of purse-string versus stitch closure of the deep inguinal ring (DIR). Patients and methods The study included 84 children who had unilateral IIH, and they were randomly divided into two groups: group I included patients who underwent sac disconnection and stitch closure, and group II included patients who underwent purse-string suture closure of DIR without manipulation or sac dissection. PO pain sensation was evaluated using the observational pain-discomfort scale. Time till first oral intake, length of PO hospital stay, and immediate and 6-month PO outcomes were determined. Results One patient in group I was converted to open procedure and another patient in group II required sac disconnection. Patients of group II had significantly shorter operative time, lower collective observational pain-discomfort scale pain score, and shorter time till first oral intake and duration of PO hospital stay compared with patients of group I. A total of three (3.6%) patients developed port site wound infection. At the end of follow-up, in group I, one patient developed hydrocele and three patients developed recurrent hernia, for a 6-month PO complication rate of 9.8%. In group II, one (2.4%) patient developed recurrent hernia. Conclusion Application of laparoscopic purse-string suture closure of the DIR shortens operative time, time till first oral intake, and home return of children with unilateral IIH with low 6-month recurrence rate than disconnection and stitch closure of the DIR (2.4 vs. 7.3%). | ||||
| Keywords | ||||
| children; laparoscopic purse-string suture deep ring closure; recurrence rate; unilateral indirect inguinal hernia | ||||
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